Animal Adoption at People Assisting Animals in Need

Adopting a pet is a very big responsibility and should be considered very seriously and include all members of the household. Each animal has unique characteristics; in order to help us place our animals in a suitable household, please take a few minutes to fill out this questionnaire as accurately and detailed as possible. Each adoption is a commitment to provide a safe, happy and healthy environment for the lifetime of your new pet. Please submit your application

Adopting a pet is a 10-15 year commitment, please consider this timeframe of commitment, the animals needs as it grows, time and training are needed for a successfull lifetime commitment to all pets. Thank you for choosing rescue to adopt your new family member.

Only serious inquiries on adopting should be submitted. To adopt a pet you must be at least 23 years of age.

General Info

Full Name:

Spouse:

Email Address:

Phone Number:

Street Address:

City:

State:

Zip Code:

Occupation:

Spouse Occupation:

What pet are you wanting to adopt?:

How did you hear of us?:

Why do you want to adopt a pet?:

Household Information

# of Adults:

Age of adults:

# of children:

Ages of children:

Are all members in the home in agreement with adopting this pet?
Yes No Half and Half

Does anyone in the household have any allergies to pet hair/dander (select one)?
Yes No

Will a growing family change your ability to home and care for your pet?
Yes No Maybe No plans to grow our family

Living quarters?

Are pets allowed? Yes No

Any restrictions? Yes No

If rent-landlord approval? Yes No

Habitat Information

Is a yard available? Yes No

What size is the yard?

Is it fenced in? Yes No

If you have a fence - how high is it?

If NO fence is available - how will you contain your pet outdoors?

Do you live in a high traffic area? Yes No

If you move and pets are not allowed - what will you do with your pet?

Hours a day pet will be left alone?

Where will the dog/puppy stay when left alone?

Where will the pet sleep?

Do you plan to take your dog/puppy to obedience training?
Yes No

If adopting a cat - would you allow your cat to go outdoors?
Yes No

If you experience behavioral problems with your pet what will you do?

Is this your first pet? Yes No

If you have/had other pets-

Provide the type of pet?

Male or female? Male Female

Spayed or Neutered? Spayed Neutered

Current on vaccines? Yes No

Age and current locations?

Current/Past Veterinarian(s) or Clinic(s)?

May we call them? Yes No

Phone number of Veterinarian Clinics listed above:

Tell us about current and prior pets

Have you ever had to surrender a pet? Yes No

If yes please explain

Will you provide annual OR AS NEEDED medical treatment and check-ups for your pet?
Yes No

Are you prepared to start your new pet on heartworm prevention at the time of adoption?
Yes No

Would you like your pet microchipped? Yes No

Are you aware that additional vaccinations are necessary for your pet besides what is covered by the adoption fee?
Yes No

Will your new pet be seen by a vet? Yes No

If YES When?

References (2 non-family relatives)

Name1 - Phone - Relationship

Name2 - Phone - Relationship

Additional Information

Will you contact PAAIN with any problems or concerns...or circumstance that may lead you to surrender your adopted pet?
Yes No

What challenges and/or satisfaction will this pet bring to you and your family?

Additional comments to assist us in the adoption process:

Are you willing to accept a 24-48 hour waiting period (if needed ) for application approval?
Yes No

* Security Check

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